Intercostals Nerve Freezing Technique for Analgesia on Post-operative Chest: A Randomized Controlled Trial_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

Department of Thoracic Surgery, Zhongshan Hospital of Xiamen University, Xiameng 361003 Fujian, P. R. China;

Corresponding author：

Keywords：

Intercostals nerve freezing; Open thoracic operation; Analgesia; Randomized controlled trial

DOI：

10.7507/1007-4848.20160009

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Objective To discuss the clinical effects of intercostals nerve freezing technique for analgesia on post-operative chest. Methods We included 80 patients with thoracotomy in Zhongshan Hospital in Xiamen University between June 2013 and June 2014. The patients were divided into a trial group (30 males and 10 females at average age of 59.90± 10.62 years) and a control groups (28 males and 12 females at average age of 59.85± 10.52 years) by random digital table. The patients in the trial group were treated with frozen the intercostals nerve roots located in the incision and next intercostals before closing the chest by cryotherapy therapy apparatus (K520 type, Beijing Kulan Company). The patients in the control group were treated with self-control intravenous analgesia pump post-operation. We compared the postoperative incision pain and cough, sputum reflection score, and pulmonary complications between the two groups. Results The pain degree in the trial group was significantly weaker than that in the control group on the first day, the second day and the seventh day after operation (t=-6.45, -4.95, -3.14, P < 0.05). Cough, sputum reflection score were significantly higher than those in the control group (P < 0.01). Pulmonary complications were significantly lower (t=3.023, P < 0.05). There were 4 patients with pneumonia and no pulmonary atelectasis in the trial group. While there were 8 patients with pneumonia in the control group and 1 patient with pulmonary atelectasis. Conclusion Intercostals nerve freezing technique can drastically reduce postoperative pain in the patients with open thoracic operation, effectively promote patient cough and expectoration, and reduce pulmonary complications rate.

Citation： HEJian-bing, DUANHong-bing, KANGJian-le, KESun-kui, WUZhao-hui, HEZhe-feng, LIMin-jie. Intercostals Nerve Freezing Technique for Analgesia on Post-operative Chest: A Randomized Controlled Trial. Chinese Journal of Clinical Thoracic and Cardiovascular Surgery, 2016, 23(1): 34-37. doi: 10.7507/1007-4848.20160009 Copy

1.	顾恺时, 主编.胸心外科手术学.北京:人民卫生出版社, 1985. 62.
2.	曾玉山, 黎萍.开胸术后肋间神经冷冻治疗对术后切口镇痛疗效的临床研究(附30例分析).吉林医学, 2012, 4(11) : 2246-2248.
3.	郎保平, 陈国生, 张宇.开胸冷冻后不同镇痛方法的疗效比较分析.中国综合临床, 2003, 19(6): 540-541.
4.	Wagner R, DeLeo JA, Heckman HM, et al. Peripheral nerve patho-logy following sciatic cryoneurolysis: relationship to neuropathic behaviors in the rat. Exp Neurol, 1995, 133(2): 256-264.
5.	Callesen T, Beeh K, Thoru PJ, et al. Cryanalgesia: effect on posth-erniorrhaphy pain. Anesth Analg, 1998, 87(4): 896-899.
6.	Nelson RM. Intraoperative intereostal nerve freezing to prevent post thoracotomy pain. Ann Thorac Surg, 1974, 18: 280.
7.	倪斌, 马海涛, 秦涌, 等.镇痛治疗方法对开胸术后患者心肺并发症的影响.中国疼痛医学杂志, 2007, 13(6): 334-337.
8.	孙洁群, 苏婉婷, 李佩贤.开胸术后冷冻肋间神经镇痛效果的观察与研究.当代医学, 2008, 12(14): 44-45.
9.	Kehlet H. Multimodal approach to control postoperative pathoph-ysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
10.	Rogers ML, Duffy JP. Surgical aspects of chronic post-thoracotomy pain. Eur J Cardiothorac Surg, 2000, 18(6): 711-716.
11.	Sandler AN. Post-thoracotomy analgesia and perioperative outcome. Minerva Anestesiol, 1999, 65(5): 267-274.
12.	Walsh EM. Methods of post-thoracomy analgesia. Br Janaesth, 2002, 89(1):184-185.
13.	张晓, 郎保平.肋间神经止痛在开胸术中的应用.中华外科杂志, 2003, 8(8): 6-9.
14.	Mainwand MO, Makey AR. Cryoanalgesia aft er thoracotmy. J Thorac Cardiovasc Surg, 1986, 92: 291.
15.	Tovar EA. Minimally invasive approach for pneumonectomy culminating in an outpatient procedure. Chest, 1998, 114(5): 1454-1458.
16.	Moorjani N, Zhao F, Tian Y, et al. Effects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostals nerves: a human prospective random ized trial and a histological study. Eur J Cardiothorac Surg, 2001, 20(3): 502-507.
17.	庞文广, 黄凤柳, 叶敏.肋间神经冷冻术在胸部手术后镇痛的临床研究.中国现代医生, 2011, 8(49) : 48-50.
18.	Topalski-Fistes N, Bujas M, Pjević M, et al. Infertility and endometriosis. Med Pregl, 1997, 50(1-2): 15-17.
19.	Kehlet H. Multimodal approach to control postoperative pathoph-ysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
20.	赵凤瑞, 田燕雏, 刘德若, 等.肋间神经冷冻止痛的实验及临床研究.中华外科杂志, 2001, 39(11): 852-854.

1. 顾恺时, 主编.胸心外科手术学.北京:人民卫生出版社, 1985. 62.
2. 曾玉山, 黎萍.开胸术后肋间神经冷冻治疗对术后切口镇痛疗效的临床研究(附30例分析).吉林医学, 2012, 4(11) : 2246-2248.
3. 郎保平, 陈国生, 张宇.开胸冷冻后不同镇痛方法的疗效比较分析.中国综合临床, 2003, 19(6): 540-541.
4. Wagner R, DeLeo JA, Heckman HM, et al. Peripheral nerve patho-logy following sciatic cryoneurolysis: relationship to neuropathic behaviors in the rat. Exp Neurol, 1995, 133(2): 256-264.
5. Callesen T, Beeh K, Thoru PJ, et al. Cryanalgesia: effect on posth-erniorrhaphy pain. Anesth Analg, 1998, 87(4): 896-899.
6. Nelson RM. Intraoperative intereostal nerve freezing to prevent post thoracotomy pain. Ann Thorac Surg, 1974, 18: 280.
7. 倪斌, 马海涛, 秦涌, 等.镇痛治疗方法对开胸术后患者心肺并发症的影响.中国疼痛医学杂志, 2007, 13(6): 334-337.
8. 孙洁群, 苏婉婷, 李佩贤.开胸术后冷冻肋间神经镇痛效果的观察与研究.当代医学, 2008, 12(14): 44-45.
9. Kehlet H. Multimodal approach to control postoperative pathoph-ysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
10. Rogers ML, Duffy JP. Surgical aspects of chronic post-thoracotomy pain. Eur J Cardiothorac Surg, 2000, 18(6): 711-716.
11. Sandler AN. Post-thoracotomy analgesia and perioperative outcome. Minerva Anestesiol, 1999, 65(5): 267-274.
12. Walsh EM. Methods of post-thoracomy analgesia. Br Janaesth, 2002, 89(1):184-185.
13. 张晓, 郎保平.肋间神经止痛在开胸术中的应用.中华外科杂志, 2003, 8(8): 6-9.
14. Mainwand MO, Makey AR. Cryoanalgesia aft er thoracotmy. J Thorac Cardiovasc Surg, 1986, 92: 291.
15. Tovar EA. Minimally invasive approach for pneumonectomy culminating in an outpatient procedure. Chest, 1998, 114(5): 1454-1458.
16. Moorjani N, Zhao F, Tian Y, et al. Effects of cryoanalgesia on post-thoracotomy pain and on the structure of intercostals nerves: a human prospective random ized trial and a histological study. Eur J Cardiothorac Surg, 2001, 20(3): 502-507.
17. 庞文广, 黄凤柳, 叶敏.肋间神经冷冻术在胸部手术后镇痛的临床研究.中国现代医生, 2011, 8(49) : 48-50.
18. Topalski-Fistes N, Bujas M, Pjević M, et al. Infertility and endometriosis. Med Pregl, 1997, 50(1-2): 15-17.
19. Kehlet H. Multimodal approach to control postoperative pathoph-ysiology and rehabilitation. Br J Anaesth, 1997, 78(5): 606-617.
20. 赵凤瑞, 田燕雏, 刘德若, 等.肋间神经冷冻止痛的实验及临床研究.中华外科杂志, 2001, 39(11): 852-854.

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Intercostals Nerve Freezing Technique for Analgesia on Post-operative Chest: A Randomized Controlled Trial

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